Malcolm White runs Hospital Transfers, a company that transfers non-emergency patients to and from hospitals and other medical facilities.

Photographed by:Jenelle Schneider Jenelle Schneider, Vancouver Sun

VANCOUVER — Malcolm White’s business idea started the way so many do — with a casual conversation about how things are done better elsewhere.

When White’s visiting son told him U.K. ambulances were overworked and the solution was a private service for non-emergency transportation, White saw the logic immediately.

“The pattern here is almost a mirror image of a similar sequence of events in the U.K. health service,” White said. “There’s a lot of movement now of patients that didn’t occur 20 to 25 years ago. You used to go to your local hospital and that was it.”

Today, hospitalized patients need to travel to specialists and get tested by expensive diagnostic machines.

White knew intuitively that starting small wouldn’t work. The key to a marketable service was jumping in with both feet. White was so sure of the idea, he hired his son as operations manager, bought six vans, hired drivers, invested in sophisticated software and plunged.

“Our first payroll was eight or nine people,” White said.

But it would be seven long years and a personal investment of $1.25 million before White finally got his first contract.

His first problem was getting an operating licence.

No fewer than 19 B.C. taxicab companies fought White’s application. After a three-day public hearing, the licence was denied. Two years later, White finally secured a licence to carry people unable to use public transit without help.

His next challenge was the B.C. health care system.

White may have been mirroring an existing British business, but for B.C. in 2003, White’s Hospital Transfers was ahead of its time.

The B.C. Ambulance Service was very busy and worried about maintaining response times. Transferring non-emergency patients meant paramedics were unavailable for 911 calls. “You can’t deposit a patient at the side of the road and dash off,” White said. Meanwhile, taxis couldn’t handle bed-to-bed service or special needs such as spinal cord patients.

“Everybody agreed it was a wonderful idea, but the hospitals couldn’t use us because there was no provision to enable them to pay us,” White said.

The ambulance service was billing the Ministry of Health. “We came along and said we can do it a lot quicker and cheaper. A nurse said to us, ‘It doesn’t matter if it costs us $2 because I don’t have a budget and the ambulance is free.’ ”

In 2005, White’s six vehicles averaged just one-and-a-half jobs per day, per vehicle.

Even though White was an experienced entrepreneur — he first fell into business ownership decades ago when a small machine company he was working for went broke and he took over — by 2008, he was thinking of quitting.

“It’s obviously an emotional roller-coaster,” he said. “We were sustained by small doses of encouragement. When somebody like G.F. decides to start using you, you hope (business is going to take off) in six weeks, but six months later, you’re doing a great job there, everybody likes you, but nothing else has changed.”

That’s when the B.C. Ambulance Service began billing health authorities directly.

The Abbotsford-based company now has 55 vehicles and 108 employees and averages six jobs per day per vehicle. White calculates that his business has saved the provincial health care system $33 million to date.

The G.F. Strong Rehabilitation Centre, which works with spinal cord and brain injuries, does not have its own X-ray unit. “Every time anyone needs to go for an X-ray, they have to go to VGH or UBC,” White said. A significant number of transfers are hospital patients needing dialysis or cancer treatment in other facilities.

It’s a challenging business model.

Ninety-five per cent of White’s business is with B.C. health authorities and half of all health authority activity is between 10 a.m. and 2 p.m., he said.

“You have to fund the availability of the service,” said White. “We can tell you what parking bay one of our vehicles is at any time. We can tell you when they start up an engine. We can tell exactly what speed they are doing at any given point in time. It’s real-time satellite monitoring.”

White doesn’t have marketing costs, but optimum safety of patients and his staff is an ongoing concern.

“It’s a job that makes a difference. It’s not earth-shattering. We go and pick up a little old lady who is very stressed and frightened and is told she’s being taken from here to there. She doesn’t quite know why she’s going there. Our job is to make the best of that situation.”